Anterior interbody fusion in the treatment of cervical spine injury.

In the period from 1967 to November 1981, 502 patients with cervical spine injuries were treated surgically using anterior interbody fusion. In 282 patients the Cloward method was used and in 220 the Smith-Robinson technique. Although anterior fusion has been performed at all levels of the cervical spine we have excluded from our analysis cases of fusion of C1/C2 as we consider these constitute a separate problem. The series includes patients with complete neurological sparing as well as all degrees of severity of neurological damage. Neurological improvement was observed in 253 cases and in 72 patients with normal spinal cord function prior to surgery no deterioration occurred. Satisfactory radiological appearance with restitution of the contour of the vertebral canal and sound incorporation of the bone graft was obtained in 70% of cases, whilst failure occurred in 5%. We believe that surgical fusion should be recommended in most cases of cervical spine injury.